Time for Agency Officials to “Take Seriously” State Regulations

Two articles from the Houston Chronicle this last week should send shivers down the spine of every Texan about what kind of government his or her tax dollars are buying.

The whole contracting fiasco in the Texas Health and Human Services Commission, the state’s largest agency which spends over $34.5 billion annually, is apparently just a symptom of a much deeper problem within this immense bureaucracy.

Agency officials can disregard state regulations with impunity

The reason for this scandal, per the Chronicle, is that there is no check or balance on the conduct of agency officials because there is nothing holding their feet to the fire to follow state regulations. And legislators apparently don’t know how to make them.

The Chronicle detailed this unsettling fact in “State contracting safeguards only as good as the enforcement.” The article states: “A renewed effort to evaluate state contracting oversight could end up illustrating an uncomfortable reality, former lawmakers and government watchdogs say even the strictest of safeguards will not work if not taken seriously by agency officials.”

That is a pretty dismal state of affairs for Texas.

The story noted that there have been safeguards in place for years on contracting but such were successfully avoided by Jack Stick and others in the 21CT affair over Medicaid fraud detection software.

Rogue behaviour not just with contracting but shown in misuse of SB 1803 with Medicaid providers

This type of apparent rogue culture is unfortunately not only seen in contracting but is observed in the way SB1803 was used this last year by OIG officials to continue to deny Medicaid providers under investigation due process. OIG used 1803 to demand outrageous advance sums for court costs which providers couldn’t afford. This effectively denied them access to a hearing to determine their guilt or innocence on the allegations against them.

SB 1803 was fought for to guarantee due process rights for Medicaid providers but was subverted by agency bureaucrats to deny those same rights.

Shown in no respect for State Office of Administrative Hearings decisions

This behavior is also evidenced by the lack of respect HHSC and OIG officials have shown for the State Office of Administrative Hearings and its decisions. Only two dental practices have been able to go before SOAH judges, Harlingen Family Dentistry and Antoine Dental. Both were found innocent of charges of Medicaid fraud, waste and abuse but these impartial findings did not influence HHSC or OIG.

OIG to refused to give back to HFD the $1.2 million that they had withheld under their “credible allegation of fraud” payment hold until HFD brought and won a motion on the return of funds before Travis Country District court and finally the state appeals court.

In Antoine Dental’s case, the SOAH finding of innocence rendered after four days of hearings before two impartial judges was simply wiped out by HHSC’s own appeals court which “cut and paste” the prosecution’s submissions into its decision.

For Antoine, it is as if the SOAH hearing held at great expense to the practice, never happened.

Protecting Xerox and blaming Medicaid providers for own incompetence

The state’s suit against Xerox, its former Medicaid claims administrator, admits that bureaucrats in HHSC knew back in 2008 that Xerox was not living up to its contract on providing qualified dental personnel to oversee the growing Medicaid orthodontic prior authorization program. HHSC knew that Xerox’s personnel had minimal dental training, worked from home and just rubber stamped each request yet agency officials did nothing to rectify matters.

Once this incompetence came to public notice in 2011, again by media exposure like the contracting scandal, agency officials targeted dental Medicaid providers as the cause although they had led those same providers to believeeach and every request for Medicaid orthodontic treatment was properly reviewed and approved by qualified Xerox dental staff.

In fact, one provider was told by former Inspector General Doug Wilson, just before this media ran, that the whole Medicaid orthodontic debacle had nothing to do with Xerox. Several weeks later though Xerox was dropped as the state’s Medicaid contractor and sued by the state.

No penalties for agency officials in contrast to Medicaid providers

Jack Stick’s custom-made $2,800 executive chair

The second Chronicle story published last week is just a further illustration of the same theme. The article “Records show controversial contract cost state more, produced less” notes that the 21CT contract and its software really didn’t do anything more than the legacy anti-fraud software that HHSC already had. Big surprise. Millions wasted again.

One has to ask how it is possible that HHSC has gone from one scandal to another over the years with untold hundreds of millions of taxpayer dollars wasted with no bureaucrat ever being held accountable. Like Xerox, like other contracts, like $2,800 custom-made executive chairs, like $100,000 grants to aides for their MBAs from state funds in violation of state regulations, etc. etc.

Where are some penalties, even prosecutions now months after these have come to light?

It certainly contrasts to the treatment of Medicaid providers who get tagged with the word “fraud” pretty damn easily.

Not taking regulations seriously is criminal behavior and should be treated as such

Not taking state regulations seriously, that is criminality, isn’t it? A thief doesn’t take laws against stealing “seriously.”

We have a solution to rogue state officials if state regulators don’t.

State employees have a duty to people of Texas, not their bosses

It is our view that state bureaucrats should be discouraged from supporting criminality within state agencies and encouraged that it is their duty to Texas to come forward to blow the whistle on violations of state regulations and laws by agency officials. It should be made easy for them to do so. There are already laws in place for this.

If they do not come forward, they should not be able to hide behind fears for their job as the reason. There are safeguards.

Agency personnel must report rogue behavior or be dismissed

When someone in the public service has knowledge of wrongdoing within an agency but does not report it and it becomes known that they knew, it should be cause for immediate dismissal if not further action as an accessory.

They did not do their primary duty to the State of Texas and its citizens, protecting the state. Instead, the person attempted to protect their own skin and allowed themselves to become an accessory to a crime. It is not acceptable that the state employ such individuals who do not hold its interests foremost.